Pattern of Emergency Neurologic Morbidities in Children: RESULTS

13Oct 2009

Six-hundred-four patients were admitted with neurological morbidity consisting of 15.6% out a total of 3,868 patients admitted during the five-year period. One-hundred-ninety-eight patients (32.8%) had incomplete records with regards to outcome. A breakdown of the number of patients per year is shown in Table 1.

Males consisted of 321/604 (53.1%), while females were 283/604 (46.9%), giving a ratio of 1.1:1. The age ranged from one month to 16 years, with modal age group of 1-2 years. Children aged five years and under constituted 77.2% of the patients studied. Neonates were not included, because they are admitted into a special care baby unit that caters to critically ill children in this category. Table 2 shows the age group distribution of the patients. avodart medication

Table 1. Distribution off Patients Admitted per Year

Year

Number off Neurologic Cases

Percent

Total Number of Admissions

Percent of Total Admissions

1996

76

12.6

490

14.7

1997

133

22.0

879

15.1

1998

130

21.5

800

16.3

1999

120

19.9

672

17.9

2000

85

14.1

628

13.5

2001

60

9.9

399

15.0

Total

604

100.0

3,868

15.6

The three major neurological morbidities seen during the period under study were febrile convulsion, 212/604 (35.1%); cerebral malaria, 169/604 (28.0%); and meningitis, 163/604 (27.0%). Together, these three accounted for 92.0% of all neurological morbidities seen. Other morbidities seen are shown in Table 3.

Table 2. Age Group Distribution of Patients

Age Group

Number

Percent

<1

145

24.0

>l-2

155

25.7

>2-3

92

15.2

>3-5

74

12.3

>5-10

82

13.6

>10

56

9.3

Total

604

100.0

In children aged five years and under, febrile convulsion was the most common neurological morbidity (42.5%), followed by cerebral malaria (32.2%) and meningitis (19.9%). In children aged 5-10 years and those above 10 years, meningitis was the commonest, 37.8% and 69.6% respectively. clopidogrel 75 mg

Table 3. Distribution of Neurological Morbidities

Neurologic Morbidity

Number

Percen

Febrile convulsion

212

35.1

Cerebral malaria

169

28.0

Meningitis

163

27.0

Epileptic seizures

30

5.0

Head injury

7

1.2

Encephalitis

6

1.0

Alcohol induced coma

3

0.5

Gullian Barre syndrome

CO

0.5

Psychosis

CO

0.5

Tetanus

CO

0.5

Syncope

2

0.3

Hydrocephalus

1

0.2

ICSOL

1

0.2

Migraine

1

0.2

Total

604

100.0

Figure 1 shows the seasonal variation in the incidence of the neurological morbidities. The incidence of febrile convulsion and cerebral malaria was highest in the third quartile of the year (July to September), with febrile convulsion being significantly highest in August, while the incidence of meningitis was about equal in the second, third and fourth quar-tiles (April to December). Of the 406 patients with complete records, 64 (15.8%) died, while 342 (84.2%) were either discharged home or transferred to the main pediatric ward. Cerebral malaria and meningitis accounted for all the deaths, 38/64 (59.4%) and 26/64 (40.6%), respectively. Forty-three (67.2%) of the 64 deaths occurred within 24 hours of admission, while 47 (73.5%) within 48 hours and 17 (26.6%) after 48 hours. Children aged five years and under accounted for 48 (75.0%), while those ages 5-10 years accounted for nine (14.1%); those above 10 years were seven (10.9%). generic simvastatin

Figure 1. Seasonal variation in the incidence of neurologic morbidities